D. Shah - The Royal College of Physicians and Surgeons of Canada

The improvement in laparoscopic task
learning using whole body video
monitoring and feedback in a
laparoscopic simulation laboratory
Author: Shah, D. Torrent, DJ. Nifong, WL. Spaniolas, K. Walsh, D. Haisch,
CE.
Date: September 30, 2016.
I do not have an affiliation (financial or otherwise) with a
pharmaceutical, medical device or communications organization.
Je n’ai aucune affiliation (financière ou autre) avec une
entreprise pharmaceutique, un fabricant d’appareils
médicaux ou un cabinet de communication.
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Outcomes
• Benefits of laparoscopy
• Haptic feedback
Faster recovery times
• Infrared feedback
Less postoperative pain
• Videography
Decreased costs
Golf
Earlier return to work
Suturing
• Simulation as a training
tool
Outcomes
• Primary
» Time difference
• Secondary
» Gender
» Glove Size
» Laparoscopy case participation
Purpose: Assess the benefits of videography on
laparoscopic skill training and skill acquisition
Methods
• Introductory laparoscopy skills lab
• 3rd year medical students
• FLS Peg Transfer

IRB approval

Prospective, randomized
Study Arms
Non-video
Video
Laparoscopic field
Laparoscopic field
feedback
feedback
Verbal feedback
Verbal feedback
Video feedback
Timeline
Week 1
Week 3
Videography
Videography
Methods
• Laparoscopic cases
• Time difference calculated
Positive = faster
Negative = slower
• Univariate and multivariate analysis
Population Demographics
n = 47
Mean or n
% or SEM
25
22
46.8%
53.2%
22
24
47.8%
52.2%
Age
26.4
0.493
Initial Time
85.0
4.63
Interval Time
56.7
3.06
Change
27.4
2.75
Gender
Male
Female
Group
Video
Non-Video
Differences by Group
Video
Non-Video
p value
Mean or N
% or SEM
Mean or N
% or SEM
26.8
0.69
26.0
0.69
0.41
13
10
56.5%
43.5%
12
12
50%
50%
0.65
Initial Time
89.0
6.5
81.1
6.5
0.40
Change
32.1
3.8
22.8
3.8
0.09
8
15
34.8%
65.2%
3
21
12.5%
87.5%
0.07
Age
Gender
Male
Female
Lap Cases
≥2
<2
Multivariate Analysis
Time change
(seconds)
8.5
8
p = 0.008
p < 0.001
p = 0.036
Number of
Laparoscopic Cases
Initial Time
Video
7.5
7
6.5
6
5.5
5
Discussion
• Importance of simulation in surgery
• Video feedback is an effective method for teaching
Enhance learning
Furnish surgeons with operative skills
• Simple, cost effective
Limitations
• Student population
Lower change of maladaptive habits
More amenable to change in technique
Conclusion
• Benefit of video feedback
• Low cost
• Surgeon proficiency
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